| NPI | 1013104652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN282887) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5009017) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A-117398) | |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2022-07-14 |